口服中成药治疗糖尿病并发周围神经病变的网状Meta分析  

Network Meta-Analysis of Oral Chinese Patent Drugs in Treatment of Diabetic Peripheral Neuropathy

作　　者：谢文莹 李文慧 张晨[1] 辛竞妍 张涛静[3] XIE Wenying;LI Wenhui;ZHANG Chen;XIN Jingyan;ZHANG Taojing(Beijing University of Chinese Medicine,Beijing 100029,China;China Academy of Chinese Medical Sciences,Beijing 100091,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院,北京100091 [3]北京中医药大学东方医院,北京100078

出　　处：《世界科学技术-中医药现代化》2024年第11期2888-2904,共17页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会面上项目(82374268):糖络宁调控雪旺细胞源外泌体lncRNA MALAT1传递减轻DPN炎症反应机制研究,负责人:张涛静。

摘　　要：目的运用网状Meta分析比较评价中成药治疗糖尿病周围神经病变(Diabetic peripheral neuropathy,DPN)的疗效及安全性。方法从PubMed、Cochrane Library、EMbase、Web of Science、中国知网(CNKI)、维普(CCD)、万方(CSPD)、中国生物医学文献服务系统(SinoMed)数据库中搜集中成药治疗DPN的随机对照试验(RCTs),使用Cochrane评价手册5.3版本的风险偏倚评估工具对研究进行质量评价,并利用Stata 15和ADDIS 1.16.5统计软件进行数据分析。结果有48项RCTs,涵盖了4200名患者,并研究了11种中成药。对于提高临床总有效率而言,最为有效的干预措施为甲钴胺联合糖脉康颗粒、联合津力达颗粒、联合脑心通胶囊;在改善多伦多临床评分系统(TCSS)评分方面,排名前三的干预措施为甲钴胺联合脉络宁口服液、联合木丹颗粒、联合血府逐瘀胶囊;在改善正中感觉神经传导速度(SCV)方面,表现出最佳效果的干预措施是甲钴胺联合通心络胶囊、联合血塞通软胶囊、联合复方血栓通胶囊;在改善腓总SCV方面,表现出最佳效果的干预措施是甲钴胺联合血府逐瘀胶囊、联合津力达颗粒、联合脉络宁口服液;在改善正中运动神经传导速度(MCV)方面,排名前三的干预措施为甲钴胺联合通心络胶囊、联合银丹心脑通软胶囊、联合糖脉康颗粒;在改善腓总MCV方面,排名前三的干预措施为甲钴胺联合血塞通软胶囊、联合银丹心脑通软胶囊、联合通心络胶囊;在改善血糖水平方面,部分研究报道了糖脉康颗粒和通脉降糖胶囊联合甲钴胺在改善糖化血红蛋白(HbA1c)水平方面优于单纯甲钴胺治疗;在安全性方面,甲钴胺联合中成药与单纯甲钴胺治疗相比,未增加不良反应的发生。结论甲钴胺联合中成药可以提高临床疗效,改善TCSS评分,改善神经传导速度,且安全性良好,为临床用药提供一定的参考。Objective Network Meta-analysis was used to compare and estimate the therapeutic effect and safety of oral Chinese patent drugs in treatment of diabetic peripheral neuropathy(DPN).Methods PubMed,Cochrane Library,EMbase,Web of Science,China National Knowledge Infrastructure(CNKI),Chinese Citation Database(CCD),China Science Periodical Database(CSPD)and SinoMed was retrieved to collect randomized controlled trials(RCTs),which were related to oral Chinese patent drugs in treatment of DPN.Cochrane Handbook 5.3 was used to assess the quality of the studies,and Stata 15 and ADDIS 1.16.5 were utilized to analyse data.Results 48 RCTs were included,including 4200 patients,involving 11 kinds of Chinese patent drugs.In terms of improving clinical total effective rate,the top three interventions were mecobalamin combined with Tangmaikang granules,Jinlida granules and Naoxintong capsules.The top three interventions for improving toronto clinical scoring system(TCSS)were mecobalamin combined with Mailuoning peroral liquids,Mudan granules and Xuefuzhuyu capsules.In the aspect of improving sensory conduction velocity(SCV)of median nerve,the top three interventions were mecobalamin combined with Tongxinluo capsules,Xuesaitong soft capsules and Fufangxueshuantong capsules.The top three interventions for improving SCV of peroneal nerve were mecobalamin combined with Xuefuzhuyu capsules,Jinlida granules and Mailuoning peroral liquids.In terms of improving motor conduction velocity(MCV)of median nerve,the top three interventions were mecobalamin combined with Tongxinluo capsules,Yindanxinnaotong soft capsules and Tangmaikang granules.The top three interventions for improving MCV of peroneal nerve were mecobalamin combined with Xuesaitong soft capsules,Yindanxinnaotong soft capsules and Tongxinluo capsules.In the terms of improving blood glucose,several studies reported that Tangmaikang granules and Tongmaijiangtang capsules combined with mecobalamin could improve the level of glycated hemoglobin(HbA1c),which was superior to mecobalam

关 键 词：中成药 糖尿病周围神经病变 网状Meta分析 疗效 安全性 

分 类 号：R-058[医药卫生]